Effect of Fetal Aortic Valvuloplasty on Outcomes

Inclusion Criteria

• •A. All of the following echocardiographic criteria need to be satisfied between 23+0 and 31+6 weeks (z-scores according to Schneider et al):
• •1. Aortic valve stenosis with antegrade flow through the valve
• •2. Predominantly left-to-right shunt at the atrial level
• •3. Predominantly retrograde flow in the aortic arch between the first two brachiocephalic vessels
• •4. Qualitatively depressed left ventricular function
• •5. Left ventricular end-diastolic diameter Z-score \> ±0
• •6. Left ventricular inlet length in diastole :
• •1. Gestational age ≤ 24+6: Z-score \> ±0
• •2. Gestational age 25+0 to 27+6: Z-score \> -0.75
• •3. Gestational age ≥ 28+0: Z-score \> -1.50
• •7. Mitral valve diameter in diastole Z-score \> -2.0
• •B. All of the following postnatal treatment options need to be available: 1. Surgical or catheter based aortic valvotomy 2. Ross-Konno surgery 3. Norwood or hybrid stage-one surgery